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HI Everyone, :laugh: I am really really struggling...I am seriously having the fight the insurance co & my PCP blues. Pasted below is draft copy of a letter that I am working on to send to the insurance co. and maybe even the insurance consumer division. Although a really tight squeeze for now, I am working on Plan B. Dr. Alvarez in Mexico, 9750 for sleeve. Here struggling...having gained 18 pounds since September 15--all of my clothes are fitting way way way toooooo tightly! Bumming Here's my letter! I just dont know what to do.... Any insight is greatly appreciated! I am not sure if I should be outright saying I want to request an appeal or just asking for an update. Please review and give me your insight. Thanks! Group/ID Number: XOH842901948/H06800 Primary Care Physician: Dr. Derek Kelly Diagnosis: 278.01 Morbid Obesity Procedure: 99241 Office Consultation Referred For: Office Consultation Requested: 12/9/08 Denied: 12/9/08 Services Requested: Consult with Dr. Vitello for a Sleeve Gastrectomy Referral Authorization No. 23,562'Denied (Referral Denied'This is a request for an out of network non-contracted provider with Managed Health Care Associates Managed Health Care Associates 2740 W. Foster Avenue, Suite 411 Chicago, Il 60625 FAX: 773-271-0264 Illinois Department of Insurance Consumer Division 100 W. Randolph Street Suite 15-100 Chicago, IL 60601 Greetings I a writing to formally request an updated status of the referral decision rendered in December 2008. First of all, the services requested are inaccurate. Since October 2007, Dr. Derek Kelly has provided referral authorizations for me to see Dr. Vitello regarding lapband adjustment. From October 2007 until September 2008, I visited Dr. Vitello for lapband adjustments and presented with complications of my adjustments on a monthly basis. Resultingly, September 2008, I had to have emergency surgery to remove my lapband due to slippage. I followed up with post-operative care with Dr. Vitello, who then consulted with me regarding revisional bariatric surgery. In the interim, I informed Maria, of Dr. Kelly's office and contacted the BCBS of IL to be advised of my benefits coverage and protocol for seeking revisional surgery. At that time, I was advised of the criteria for coverage, which I meet now and did so at the time of request, and advised Maria of the same. She advised me to have Dr. Vitello submit the referral authorization and that she would handle the request, as she had handed the processing of all of my prior referral authorizations to Dr. Vitello. Upon mutual interest, Dr. Vitello petitioned for referral authorization for revisional bariatric surgery, vertical sleeve gastrectomy. My last follow up appointment with Dr. Vitello was October 31 and the referral authorization was submitted twice by Dr. Vitello's staff (University of Illinois at Chicago) before warranting a response by the Managed Care Group. This petition submitted in full disclosure, my operative and post-operative reports and medical necessity substantiating the need for the procedure. According to my insurance terms, bariatric surgery is a covered benefit as long as it is deemed medically necessary; this is furthered for revisional bariatric surgery with indication that as long as the first bariatric surgery was medically necessary, there is no waiting period for clearance for the authorization of a revisional surgery. Additionally, according to my policy's terms and conditions, I have been advised of the following: Repeat of a covered bariatric surgery may be eligible for coverage only when ALL of the following criteria are met: For the original procedure, patient met all of the screening criteria, including BMI requirements The patient has been compliant with a prescribed nutritional and exercise program following the original surgery Significant complications or technical failure (i.e., slippage, etc.) of the bariatric surgery has occurred that required take down or revision of the original procedure that could only be addressed surgically Patient is requesting reinstitution of an acceptable bariatric surgical modality. Dr. Vitello submitted his referral authorization to Dr. Derek Kelly indicating my request to reinstitute an acceptable bariatric surgical modality, vertical sleeve gastrectomy. On December 9, I received paperwork advising of a decision of denial for a consultation. It indicated the denial was based on the fact that the services are available in-network and the request was from a non-contracted provider. The basis of this claim request for out-of-network coverage is due to this surgical procedure being revisional bariatric surgery, which is an acceptable bariatric surgical modality. Secondly, the letter advised of an alternative for the non-approved service, to contact Dr. Kelly for a referral to an in-network specialist. On December 15, 2008, I met with Dr. Kelly in follow-up to the denial. Dr. Kelly advised that he needed to submit supplemental supportive documentation along with the referral for processing to secure an affirmative decision. Dr. Kelly then proceeded to review my operative report records from the surgery and reviewed my other health records in my medical file and interviewed me regarding my health status. Dr. Kelly indicated this procedure should take approximately 30 days maximum and to anticipate an affirmative response to proceed with revisional bariatric surgery and that I had his medical support in substantiating the medical need. I have been waiting since December 15, 2008 and to date am more frustrated now than ever. For the past 2.5 months, I have meticulously called Dr. Kelly's office regarding a status update. Maria, the administrative assistant, has provided several updates. The updates have included the fact that the previous medical director retired and was replaced and the new director was then on vacation, to the medical director making request for additional paperwork (which was submitted), to the medical director needing to meet with Dr. Kelly regarding the details of the approval process for this type of referral authorization, to the medical director and Dr. Kelly being unable to meet to further discuss the nature of my referral, to Brenda communicating that there was never a properly submitted referral from Dr. Kelley to the Managed Care group which resulted in the initial denial decision. In my first direct contact with Brenda Blazek, the Referral Coordinator who signed the referral denial letter, she claimed to know nothing regarding my case and further indicated that there was no documentation in my file. When I followed up with Maria with Dr. Kelley's office, she advised that Brenda did not find any information in my file because all of the information was being held by the medical director. Whatever the real case is, this is neither professional nor acceptable in accordance to my patient's rights under section 502(a) of ERISA. Just yesterday, I called and spoke with Maria five times to get an updated status, to exhaustedly be declined, yet promised an update by the end of the work day. I have not spoken with Maria, nor have I missed an update call from Maria. This has been my experience for the last 2.5 months. Below is an excerpt of the fax sent to Dr. Kelly, which was confirmed as received by Maria on February 5, 2009. Maria, I would like to reiterate that on 12/9 the referral authorization stated that the procedure, Vertical Sleeve Gastrectomy, is a covered benefit in-network; however my request was to have the procedure done by an out of network provider. Additionally, this was confirmed by Tammy on yesterday at 12:50 with Blue Cross Blue Shield that this is a covered medical benefit as long as it is deemed medically necessary. My appointment with Dr. Kelly in December was to have provided me with a specialist referral to have the procedure done or we could have executed an appeal. I think Dr. Kelly submitted an appeal for coverage of the procedure; however, I am requesting to have this surgical procedure done by Dr. Vitello or be advised of the in-network provider who can perform this surgical procedure. Even in accordance to the appeals process, the timeline has been elongated to address issue of medically necessity when that is not the matter'the issue is approval for out-of network coverage or referral to an in-network specialist. I hope this clarifies the situation more. I will call you tomorrow to see if you have an updated response. Additionally, I was contacted by the non-contracted provider's office as a follow-up to the request in January and February. Last week, I advised them of the insurance referral hassle that I have been experiencing and they formally resubmitted their request, directly to Dr. Kelly (attention Maria), to the medical director of the Managed Care Group and to Brenda Blazek. To date, no response has been received; however, they have confirmed receipt of such documentation. Resultingly, I am assuming that since the only official documentation I have received to date is the referral denial, then I am evoking my patient right to request an appeal, specifically an expedited appeal process. However, I am highly dismayed because Dr. Kelly advised that there would be no need to execute an appeal. I would like to seek clarity first on the status and if this is in order, I would like to request an activation of the appeals process and under separate cover I will or will have my attorney to handle the appeals process. Before escalating to that level, I am very much interest in seeking resolve immediately. If and when I need to activate an appeal, I am requesting an expedited appeal process because my health at this point is continually declining and it is therefore imminent and serves my best interest to not further jeopardize my quality of life by waiting for a decision. Since December, the following symptoms I have presented: my breathing has become labored and therefore results in extreme shortness of breath my severe obstructive sleep apnea condition has worsened (hypopnea with severe oxygen desaturation) my acid reflux has returned my amenorrhea has returned and I have again began experiencing tumultuous joint, knee and lower back pains __________________ Originally posted at www.lapbandtalk.com

There are some great surgeons in Mexico, however you must be very careful when choosing one. For instance, stay away from the ones that still use the outdated 4cc bands. The 4cc bands are no longer used in the US due to their very high rate of complications, but many Mexican surgeons still use them because they can get them at a cheaper cost. Also, you need a bariatric surgeon locally to do your fills and manage your health. It's very important you find one before having surgery in Mexico because many American doctors won't touch a patient banded in Mexico so it's crucial you have one established ahead of time. Otherwise, you run the risk of coming home with a band no one to fill it or help you. Just my personal opinion, but I wouldn't go to Mexico for any form of Medical Tourism, including weight loss surgery. I just don't feel like your health is something to "shop around" for the best deal on. Best wishes.

I can not imagine allowing my medical requirements deciding on my residence, unless I was terminally ill. Though for the initial 18 months of being banded, I did reside just over an hour from my surgeon's office, with my husband's retirement we have moved to another state in a more rural area. I am now just over 2 hours away from a physician who can adjust my band. That distance has not been an inconvenience to me. I have had some complications since our move, but was able to continue to sip on liquids. It's all about the priorities we choose in life. I have a lot of living to do, and my band is not the center of my life focus. Other's mileage may and does vary...

Where is my question? I was asking what happens if a complication arises, who pays the bill... Sent from my SM-N920R4 using the BariatricPal App

Oh hey! My husband was lusting after this one so got it for him (franly yours looks a lot easier to use but he wanted this complicated one). Can't wait until we cn eat veggies properly to make something with it. Your dinner looks yummy! http://www.amazon.com/Paderno-World-Cuisine-A4982799-Tri-Blade/dp/B0007Y9WHQ/ref=sr_1_1?ie=UTF8&qid=1378093831&sr=8-1&keywords=paderno+world+cuisine+a4982799+tri-blade+plastic+spiral+vegetable

@RJ'S/beginning read you had complications, considering all you went thru would you still have baritric surgery? With all the paint etc, was it worth it? Thanks

It's complicated, I guess. I'm four weeks out, and I don't feel regret about the operation - I'm sure it'll add years to my life - but I often miss being able to eat "normally". Like, leftover pizza slice in the fridge, I look at it, and I wish I could have it. When eating with friends, they've got plates full of food, and I've got like... an eighth to a quarter. This stuff eases up over time, I know, but the thought that I'll never be able to eat a whole sandwich again makes me a bit sad.

They didnt take any blood or run labs. My bariatric doctor hasnt ran any blood work since pre-op. They gave me labs they want done and sent to them for my year check up. Luckily I have a great primary care dr and we have monitored things and other than my Vit D being a little low all labs have been great. I think my surgeon is a great surgeon and has a very very low complication rate and I am thankful for that but the follow up stinks!

Do you feel there are more post surgery complications with U.S. based doctors, since they have quite a bit less experienced than European or Mexican based doctors? How many of you had post surgery complications: e.g. flipped ports, sliped band, etc.? My port is flipped at 90 degree angle and inaccessible for adjustment. I need to have another surgery to correct it. I'm self pay and it is not going to be cheap. My dr. is U.S. based. Thanks for your opinions. Renata

Renata, I tend to think it's a relatively rare complication that is seen more because more and more bands are being done...you know, a "law of large numbers" thing. Here's a study on port placement and complications. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14738680 I would hope that my doctor read it before s/he tried to replace the port. Good luck, Sue

“I respectfully have to disagree with you. “ As many people do. “First off all I do believe that no Doctor in their sane mind would deliberately hurt another human being or intentionally install a Lap band the wrong way.” And just where did I say it was intentional or deliberate? I am certain that it WASN’T either. I believe he WAS incompetent. And, my biggest problem with him was his REACTION to me when I presented the problems. It’s that simple. “What happened to you is a rare exception and I am not in the position to judge you or your Doctor because I only know your side of the story. I am very careful with the information that I read in forums.” I have stated quite repeatedly that I KNOW that my experience was rare and unusual. But that doesn’t mean it DOESN’T happen to other people. Here’s a simple and unscientific, but legitimate observation. Take a look at this forum. Go to the front page. Look at the listing of all the various subtopics that are presented. Look for “Lap-Band Success Stories”. You’ll see that there are 47 threads and 448 posts Now, go further down. Look for “Lap band Complications”. You’ll see that there are 2,003 threads and 21,084 posts. It would appear that the Complications outweigh the Success Stories by a margin that could only be described as “vast”. Now, there are MANY reasons for this, and this is NOT an accurate measurement, but it DOES suggest that there are problems that ARE encountered by people. And my “message” to people is not to AVOID having the Lap band, rather make sure you do your homework THOROUGHLY so that you can mitigate the potential of there being problems in YOUR procedure. It’s that simple, and there should be nothing objectionable in that. And, one of the components of creating a successful surgical experience for yourself is CHOOSING the RIGHT SURGEON…..AND the RIGHT FACILITY. I am not clear AT ALL why anyone would find that concept objectionable. “At any rate, please do not take my candid words as a sign of disrespect or insult, I am just being honest.” No, I understand that, and I understand your concerns about the things I am saying. It’s not easy to hear this stuff when you are contemplating this procedure. “When I researched lapbanding I was so cautious about the entire procedure that I never thought I would actually find someone that I could really trust let alone agree to the procedure. “I am not some naive little teenager that is SOLD a surgery,” Understand that many, many people ARE naïve about this. It is an INDUSTRY. With billions of dollars at stake. And the Lap Band is the “darling” of the industry at the moment. A lot of people like to make the whole process sound very easy and rosy. Most often, it is. Sometimes it’s not. THAT is a reality. I am a highly educated woman that lived in several countries and cities and therefore carries suitcases full of life- experiences with her anywhere she goes. What I am trying to say is that I appreciate your concern and your advice but I truly believe that I can make an educated decision and distinguish between a money hungry crook and an honest, genuinely caring professional.” I never said that you WEREN’T capable of making a good decision. However, your responses in this thread would indicate that you DO have some reservations about it. And you should. It’s SURGERY. You should ALWAYS think twice or even three times before you have ANY elective surgery. And, I never said that MY surgeon was a “money hungry crook”. An incompetent brain-dead buffoon who should be slicing turkey at Subway perhaps, but not a money hungry crook. However….there ARE money-hungry crooks out there, and you do need to be aware of them. I suspect that Dr. Feiz is NOT one of those. He is probably a fine Surgeon. He probably slices turkey MUCH better than MY surgeon. “Again, I do not mean to offend you.” And I am not offended. You would know if I was. “As someone that searches for "Los Angeles" and "Cedars" I had to read at least 15 to 30 of your very detailed posts in this forum.” “I am sorry for you, I feel bad what happened to you and I wish you had a great experience like many other users on this board had. Please understand where I am coming from. I am a new user on this board and I am here to absorb the positive energy and spirit from positive people. I did not come here to be lectured about unethical or incompetent Doctors.” I often hear people say that they come here for “support and encouragement, NOT to hear bad things” or something like that. I need to point out that this forum is called “Lap Band Talk”, not “Lap Band Happy Land” Or “Band Nirvana”. People here talk about EVERYTHING with regard to the band. Not just the good stuff. You can find PLENTY of “positive” information about the surgery here, tons of terrific information about “good” doctors and positive outcomes. But I would have to seriously question your sense of reality if ALL you want to hear about is the “good stuff”. Choosing a WLS is the same as most anything else, really. When I buy a new car, I want to know its safety track record. I want to know if there have been recalls. I want to know if there is ANYTHING about that vehicle that might preclude the possibility of it being wise choice for MY requirements. Now, there MAY be something about a particular car that is a little negative, but if the GOOD outweighs the bad in an appropriate proportion, then I will most likely buy the Car because it fills some particular NEED for me….even though it might have some quirk that will annoy me. Now, with surgery, it’s a little different, but not THAT much. It’s still about your SAFETY. But if the potential POSITIVES outweigh the POTENTIAL negatives in a proportion that is comfortable for YOU, then you need to go for it. Plain and Simple. You CAN, however, have an IMPACT on those proportions by making the RIGHT CHOICES. And that’s what this about for me….making the RIGHT CHOICES. “I have arrived at a point in my life where I do not need to have EVERYTHING under control, I can very well live with the uncertainties of life itself and rather focus on the positive things and positive outcomes than to waste my time and life with worrying and negative thoughts.” “When something should go wrong I will deal with it with the same positive outlook.” You CANNOT control EVERYTHING in your life. It does take some people many years to arrive at that conclusion. It is often very liberating when you learn that important lesson. You CAN, however, significantly mitigate the possibility of something going wrong by making GOOD choices. You may not be able to change the OUTCOME of something once it is in process, but you can certainly have an impact on the way it turns out by the choices that you make going into it. “You really need to know how down lifting your posts are, especially for someone that is new here and was (until a couple of hours ago) very much looking forward to the journey she is about to embark on.” “Down lifting”? If you searched my posts outside of the Cedars references you will actually find many posts that are “Up Pushing”. I’m not an opponent of the Lap Band. I heartily encourage people to GET one, if they have determined that the Lap Band is what will help them with their particular issue. But PART of that “self-education” process HAS to be a “reality check”. Knowing the BAD stuff will HELP you make the decisions that will lead you to the GOOD stuff. I could spend the next few hours pounding out metaphors, examples, stories, etc, but the bottom line is that knowing the reality is NOT a bad thing. And knowing it should NOT keep you from having the surgery if you have determined that it IS what you need. I am VERY supportive of people moving forward on this. There are some WONDERFUL success stories in this forum, and some terrific people that will HELP you get to that “good place’ that you want to be. “I have to excuse myself now and have to take a very long shower; this negativity was just too much.” I also have to run and take a shower. But for an entirely different reason. :thumbup: Again, no disrespect intended... we just seem to be VERY different people and I don’t think lap-band-forum-life is the kind of support that will do me any good. And no disrespect was perceived. And, I think that if you knew me, you would find that we more alike than you might guess. We all have the same goals, dreams, and desires. For most of us, that includes good health. We are ALL on that path. “I am a highly educated woman that lived in several countries and cities and therefore carries suitcases full of life- experiences with her anywhere she goes.” And I have a suitcase as well. Unfortunately, mine contains a couple of half-empty bottles of Jack Daniels, some melted ice cream, some monkey food, a thong with the initials RS embroidered, and a citation from the Tucson Police Department for “lewd and lascivious conduct”. It’s a long story. Best of luck, and enjoy your journey! HH

I am 1 month out today and still having regrets. I live with a constant stomach ache and low energy even though I am eating and taking my supplements. I had complications in the hospital which kept me in for another week. I made this decision for my health, but I feel worse now than before I had this done. Sent from my LG-D851 using BariatricPal mobile app

So sorry for ur complications I also was the 22 no issues had rny went home the next day no pain meds. Back to work last Friday. Yes the ketosis SUCKS. I BRUSH MY TEETH TEN TIMES A DAY AND ITS STILL SMELSS HORRIBLE! I'm down ten pounds since since surgery. I think everyone is different. I'm praying for you and ur recovery and wish u the best. Keep us posted!!! And keep ur chin up hun!! Sent from my iPhone using the BariatricPal App

I am not doing well since my November 22nd sleeve. I was in the hospital four days and had complications. The surgeon put my sleeve too tight which was determined during my GI test the day after surgery. Liquid enters my stomach but takes a long time to exit and at a very small stream. I was told another surgery was an option or holding it out and wait for swelling to go down which could help. While in the hospital I had maybe 3 ounces of apple juice each day which was forced. I'm home now without any pain medication and it is a struggle. I'll be on clear liquids at least two weeks. I'd estimate that I'm driving maybe 10 ounces of liquid per day for the last 48 hours. I'm really getting concerned for when I will be able to drink more. It's hard to take in anything at this point because the stomach flips are so bad. My SW was 300.1, day of surgery 286.4, and today I am 274.2. I'm very surprised to be down 12.2 pounds since surgery Tuesday. I was told in the hospital to not be surprised if I go home and get on the scale to gain ten pounds. I know I haven't been eating but they gave me a lot more iv fluids because of my tight sleeve. That's my update as of now. Definitely a struggle and taking it day by day! Sent from my SM-G935P using the BariatricPal App

Hello everyone this is probably going to be long but really could use the input. Nov 2019 I had the gastric sleeve done. Since this I have had nothing but troubles. 10 days after surgery I was admitted due to blood in my belly and a hematoma on my spleen. They fixed that and discharged 3 days later. I have not been able to eat much more then let's say a chicken nugget(less then an ounce of anything including liquids) I got dehydrated was admitted again 29 days post op. Stayed for 12 days got a picc line with tpn since I can not eat or drink much. During this stay had endoscopy and they stretched a stricture lower part of stomach to intestines from 15mm to 25ish mm. Went home no change still not able to eat. Had another endoscopy and stretch this time my stomach was twisted and she tried stretching to 30mm but was only able to get to about 28mm. Went home still no change to eating and drinking. On the 16th of January I had another endoscopy stretch. Stomach was twisted again and was barely able to stretch it at all. I aspirated during the procedure. I woke up to them telling me to keep coughing to get it up. They observed me for 3hrs was on 4liters of oxygen at first then 2. I got up to pee with help my oxygen corrected itself. They said there was no need to keep me I only aspirated a tiny amount. They let me go home (2 hr drive home) I was freezing hole way hubby cranked up heat. Took temp when I got home and found I had a fever of 102.6 went to local er where they did xray and ct found I had developed pneumonia and I also had a pulmonary embolism. They felt I should go back to hospital where this happened and I stayed there for 6 days. 5 days of iv antibiotics and heparin for embolism then discharged on lovonox to continue for 6 months to a yr. I still have no change so now its crunch time it has been 3 months since and cant eat or drink much at all. They want to do another stretch which I would need to come off the lovanox which is putting my life at risk. Not to mention I have had it done 3 times and it has not helped. Also if it doesnt work i would need to have the bypass revision which means 2 procedures putting me at risk 2 times) Surgeon says only other option is revision to bypass(unless he sees scar tissue and can fix. But i have to agree to bypass incase there is no scar tissue or it cant be fixed) My family is up in arms it's hard either way. I dont want anymore procedures but I need to get stomach fixed and I need to get back to work. 3 months no pay we cant take this financially anymore. So for me I feel like they need to do the bypass and I hope for the best and have minimal complications. However the rest of family is worried I will have more complications than I have currently. Plus my sister had bypass and has had to have 15 different repairs(this makes them more worried) I could really use some insight on this what would you do? What do you think I should do?

Congratuions on completing your 6th month diet! Now you get the really good news soon, right? Questions to ask surgeon: If you have not asked already. How many sleeves have you done? What is your experience in barriatrics? What size bougie will you be using? What complications have your patients experienced right after surgery? What are the top three things I can do to make my sleeve a success? Will I be meeting with a nutritionist after surgery or do I have free access to a NUT in surgeons office to ensure successful new diet and changes? Who do I call after surgery with general questions? What kind of ongoing support is offered? Does office recommend certain suppliments? What is your preop diet/length of preop diet? How long will I be hospital or is this an outpatient surgery? (I was an outpaient for VSG and had no catheder/pain pump/drain/nurses prodding me) Do I see an internal medicine doc for follow up (your own doctor) or do you seen surgeon? Does office have a written sleeve guideline plan with what to expect? (I have several that I have collected, send me a private message if you want me to email to you) Never tried unjury, although I read a lot of people who liked the Unjury chicken broth. My taste buds really changed after surgery and everything was way to sweet for me. Could not choke down fruity or chocolate/vanilla protien shakes. After surgery, more important that you keep hydrated with electrolyes than worry about Protein. Good luck and read up on this site since there is mostly good advice provided.

I too will have to have my band removed--the date hasn't been scheduled but I have an appt. tomorrow to discuss my options. I also had good results in the beginning however after the 8th month started having complications. I have had several o/p tests with all of them coming back within "normal limits"-I cannot eat anything substantial so I am also now gaining weight. I wish you luck on whichever procedure you have and look forward to hearing about your outcome.

see link below https://www.bariatric-surgery-source.com/gastric-sleeve-vs-bypass.html I am a sleeve almost 6 years out and maintaining. Less invasive and less chance of dumping syndrome. No complications.

I had my surgery in Mexico. I followed up with my family doctor. Any specific questions I emailed or called the aftercare doctor who was assigned to me. Haven't had any issues. I also made sure before I left that I would be covered under OHIP (canadian healthcare insurance). They said they would cover if any complications.

@@JacksdadShane -- I'm a writer, work at home, so I do have a desk job - I had bypass surgery on a Thursday morning, home from hospital Saturday - on Monday, I was okay to check emails, etc., and I'd say working light and part time later that week, full-time by week 3. Of course, it helps I work at home - but, barring complications, (and everyone's different...), a couple of weeks off probably is fine -- search on here, there have been threads before about this very topic with lots of responses -- best of luck!

So I'm just curious how many people have actually went to Mexico and had their surgery? Its kinda scary to me but not as scary as my insurance telling me they will cover nothing if I have complications from this surgery. I have noticed there is insurance you can buy for any complications but it's only good for thirty days. Did anyone else have my concerns and went ahead with the surgery anyways in Mexico? What was the experience like? Anyone have Dr.Maytorena? Thanks Sent from my iPhone using the BariatricPal App

I can totally understand why with your experience you would warn anyone that was having the surgery to really weigh the pros and cons along with the complications. Having said that 60 pounds is still a lot of weight for a person to lose on their own and to be able to keep off. It is no more difficult for someone who is 100+ pounds to keep their weight off as it is for someone who is 60 pounds overweight. This really isn't about the losing of the weight as it is the maintaining of it coming off. I would venture to say to those who have lost 100+ pounds that though they may have been happy when they hit the mark of only 60 more pounds to go they were certainly not done losing weight and did not really want to hang onto that 60 pounds either. I don't think it is about the number so much as quality of life, mobility and energy to enjoy it. Here Oprah pulls 67 pounds of fat in her wagon...ya thats a lot to be carrying on a 5'3 frame like mine.

I quit smoking before my surgery as I knew that I was increasing my risks for post-op complications. Being under anesthesia holds its own risks and compromising lung function ads more risks to the ones that already exist. If you can... follow-through and quit before surgery. I started back up after surgery which was so dumb... and continued the quit/start/quit/start game for quite awhile. I quit again the end of January and I know this time it will stick. I feel and smell so much better! It was one of the hardest things I have ever done but well worth the effort! Oh... combining the nicotine patches with Zyban (wellbutrin) apparently takes a lot of the horror out of quitting... you could ask your doctor about that. :success1:

I noticed that you were thinking about going to Mexico for your band. I know lots of people have a great experience there and save lots of money. If there are no complications, it is a great deal. But have you thought about what happens if there is a complication? Do you think that an insurance company would cover the expenses for complications of a foreign installed medical device? From my experience from working at a weight loss clinic, I would say most likely not. I’m all for going to Mexico. God knows I am crazy about Tijuana tacos! My dad had major dental surgery there and so forth and it was satisfactory I guess. The thing is that if you want to save money somewhere, why go el cheapo (if you will) with your body? Take the time to save up the extra money so you have the insurance that someone will be able to take care of you that isn’t a three hour drive across the boarder. By the way, I work at a place that sees patients that does work on people with foreign bands and they come in at least every couple weeks. Granted I only hear about the bad examples and not the people that have had good experiences in Mexico. Nevertheless, based on the examples that I’ve seen, there is no way I would allow anyone in my family to get their band outside of the US.

Well, Clay, since my insurance paid for my band in Mexico, yes, i would expect them to cover complications. I really don't have any fears for that. I would probably go to Dr Ortiz for any problems I have anyway. I could have had the surgery in the US and my insurance would have paid for it, but after seeing Dr Ortiz and his clinic when my daughter went there in 2006, my husband and I felt that was definitely the right choice for us. None of the three of us has had any problem or complication whatsoever.